Lorrey Selena J, Waibl Polania Jessica, Wachsmuth Lucas P, Hoyt-Miggelbrink Alexandra, Tritz Zachariah P, Edwards Ryan, Wolf Delaney M, Johnson Aaron J, Fecci Peter E, Ayasoufi Katayoun
Department of Immunology, Duke University, Durham, NC, USA.
Brain Tumor Immunotherapy Program, Duke University, Durham, NC, USA.
Neurooncol Adv. 2023 Apr 11;5(1):vdad035. doi: 10.1093/noajnl/vdad035. eCollection 2023 Jan-Dec.
The nervous and immune systems interact in a reciprocal manner, both under physiologic and pathologic conditions. Literature spanning various CNS pathologies including brain tumors, stroke, traumatic brain injury and de-myelinating diseases describes a number of associated systemic immunologic changes, particularly in the T-cell compartment. These immunologic changes include severe T-cell lymphopenia, lymphoid organ contraction, and T-cell sequestration within the bone marrow.
We performed an in-depth systematic review of the literature and discussed pathologies that involve brain insults and systemic immune derangements.
In this review, we propose that the same immunologic changes hereafter termed 'systemic immune derangements', are present across CNS pathologies and may represent a novel, systemic mechanism of immune privilege for the CNS. We further demonstrate that systemic immune derangements are transient when associated with isolated insults such as stroke and TBI but persist in the setting of chronic CNS insults such as brain tumors. Systemic immune derangements have vast implications for informed treatment modalities and outcomes of various neurologic pathologies.
在生理和病理条件下，神经系统和免疫系统以相互作用的方式进行交互。涵盖各种中枢神经系统疾病（包括脑肿瘤、中风、创伤性脑损伤和脱髓鞘疾病）的文献描述了许多相关的全身免疫变化，特别是在T细胞区室。这些免疫变化包括严重的T细胞淋巴细胞减少、淋巴器官萎缩以及骨髓内T细胞隔离。
我们对文献进行了深入的系统综述，并讨论了涉及脑损伤和全身免疫紊乱的疾病。
在本综述中，我们提出，此后称为“全身免疫紊乱”的相同免疫变化存在于各种中枢神经系统疾病中，并且可能代表中枢神经系统免疫特权的一种新的全身机制。我们进一步证明，当与中风和创伤性脑损伤等孤立损伤相关时，全身免疫紊乱是短暂的，但在脑肿瘤等慢性中枢神经系统损伤的情况下持续存在。全身免疫紊乱对各种神经疾病的明智治疗方式和结果具有深远影响。
